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01-06-2018 | Original Scientific Report

Long-Term Survival of Recurrent Intrahepatic Cholangiocarcinoma: The Impact and Selection of Repeat Surgery

Authors: Tomoaki Yoh, Etsuro Hatano, Satoru Seo, Yukihiro Okuda, Hiroaki Fuji, Yoshinobu Ikeno, Kojiro Taura, Kentaro Yasuchika, Hideaki Okajima, Toshimi Kaido, Shinji Uemoto

Published in: World Journal of Surgery | Issue 6/2018

Abstract

Background

Definitive guidelines for recurrent intrahepatic cholangiocarcinoma (ICC) do not exist. This study has focused on the repeat surgery when analyzing the survival outcomes of recurrent ICC. We evaluated the relationship between clinicopathological features of the primary tumor and implementation of the repeat surgery to identify its potential selection criteria.

Methods

A total of 108 patients with recurrent ICC between 1993 and 2015 were analyzed. Of these, 15 patients underwent repeat surgery and 93 did not.

Results

Seven out of 29 patients with intrahepatic recurrence and eight out of 44 patients with extrahepatic recurrence were amenable to the repeat surgery. Thirty-five patients with simultaneous or consequent intrahepatic recurrence and extrahepatic recurrence were not amenable to the repeat surgery. Patients who underwent repeat surgery had a lower proportion of lymph node metastases (n = 0 [0%] vs. n = 47 [50.5%], p < 0.001), multiple tumors in the primary tumor (n = 1 [6.7%] vs. n = 31 [33.3%], p = 0.037), or early recurrence (≤ 1 year; n = 4 [26.7%] vs. n = 62 [66.7%], p = 0.003). Survival after recurrence (SAR) was better in patients who underwent repeat surgery than in those who did not (median SAR time: 91.6 vs. 10.4 months, and 3-year survival: 86.7 vs. 8.7%, respectively, p < 0.001).

Conclusions

Repeat surgery for recurrent ICC with an appropriate selection can be associated with prolonged survival. Regarding the feasibility, nodal status, number of tumors on the primary tumor, and time to recurrence may be considered as selection criteria.

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Title: Long-Term Survival of Recurrent Intrahepatic Cholangiocarcinoma: The Impact and Selection of Repeat Surgery
Authors: Tomoaki Yoh
Etsuro Hatano
Satoru Seo
Yukihiro Okuda
Hiroaki Fuji
Yoshinobu Ikeno
Kojiro Taura
Kentaro Yasuchika
Hideaki Okajima
Toshimi Kaido
Shinji Uemoto
Publication date: 01-06-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 6/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4387-7

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Long-Term Survival of Recurrent Intrahepatic Cholangiocarcinoma: The Impact and Selection of Repeat Surgery

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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